Pregnancy drinking chats ‘more successful’

Researchers find less formal conversations encourage honesty over drinking from mums-to-be

Wednesday 4th September 2019

A “conversational approach” by health professionals is the best way to discuss alcohol consumption with pregnant women, a new study has found.

Estimates suggest more than 40% of women in the UK drink during pregnancy, despite there being no known safe levels to prevent harm to their unborn baby.

Researchers at Stirling and Edinburgh universities have carried out the first major study into the use of internationally recommended alcohol screening and brief interventions (SBIs), to identify drinking habits and offer support to women.

The study found this kind of “flexible, conversational approach” was more successful in encouraging women to honest about their alcohol consumption.

It contrasts with previous research that has recommended using formal screening tools, such as structured questionnaires.

Study leader Dr Niamh Fitzgerald, of Stirling University’s Institute for Social Marketing, said: “Midwives used several strategies to facilitate honest disclosures, including taking a positive tone in conversations and exploring drinking habits prior to pregnancy or prior to when women realised they were pregnant.

“It was felt that these approaches helped build a trusting relationship between pregnant women and midwives and improved disclosure rates.”

When using more standardised questions, midwives found on several occasions that reported drinking was lower than anticipated compared to known levels of alcohol use in the area.

Dr Fitzgerald added: “It was clear that implementation leaders felt that the use of screening questions had to be flexible and not simply asked verbatim to each woman.

“A flexible, conversational approach to discussing alcohol with pregnant women was considered superior to formal tools for identifying who might benefit from intervention and needs to be formally tested.”

Alcohol use in pregnancy can cause harm to the developing foetus, including growth restrictions, low birth weight, pre-term birth, and foetal alcohol spectrum disorders.

There is little evidence of harm from very low levels of drinking, but risks increase as greater amounts are drunk more often.

A national programme of SBIs in antenatal care was rolled out in 2008, and the study is the first to exploring in detail the success in preventing harm caused by drinking during pregnancy.

Dr Fitzgerald said: “It adds to understanding of the detailed practical and ethical dilemmas involved in establishing alcohol SBI in the antenatal setting, and is likely to be relevant to other countries.”